Setting sights on the world’s largest market

If you’ve been watching the Olympics from Beijing, you no doubt caught the opening, where a sea of some 14,000 dancers performed in perfect unison. Did you notice the epidemic of obese people?

No one else did, either. But this morning, the NBC Today Show reported that China is the fattest country in the world, second only to the United States.

According to NBC chief medical editor, Dr. Nancy Snyderman, nearly ten percent of Chinese children is obese. She said that as profits in China have gotten fatter, so have kids. Increased wealth and living standards, as prosperity brings the country out of poverty, has given China an obesity problem. She blamed the main cause for China’s weight problem on the popularity of American fast food, especially KFC.

Traditional Chinese cooking wasn’t let off the hook, either. Rice isn’t fattening, she said on the air this morning, but traditional recipes fry meats in oil and that unhealthy fat was fattening. In passing, she also attributed China’s obesity problem to its one-child policy, which meant parents were more likely to spoil their kids by overfeeding them. Another contributing “problem” she told viewers, was China’s emphasis on academics for children, focused on bettering their futures, rather than athletics.

All the myths of child obesity captured in under 3 minutes.

Fact checks

The INTERMAP study, just published in the current issue of the journal Obesity, which had randomly sampled a total of 839 Chinese, found such a small number of people who were obese (BMI>30), the researchers were unable to make any correlations between dietary factors and obesity. They reported only 3% of Chinese adults were obese, even in middle age when weights are their highest.

The most recently available National Nutritional and Health Survey done on the people in China was reported in the August 2006 issue of the British Medical Journal. Dr. Yangfeng Wu, professor and chief of the Department of Epidemiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences in Beijing, reported that a total of 14.7% of Chinese were overweight and 2.6% were obese.

There are so many people in China, though, some 1.3 billion, that these low percentages in prevalence can make the total numbers sound huge. Talking about total numbers, without factoring for the growing population, can create the illusion of quite a crisis.

Because of “China’s recent history, where famine and chronic malnutrition caused the deaths of millions of people in the 1950s,” Dr. Wu wrote, body fat represents health and prosperity.

The obesity epidemic rhetoric has had to be especially intense to overcome prevailing social attitudes towards fatness. As a member of the Working Group on Obesity in China and director of the World Health Organization Collaborating Center for Cardiovascular Disease Prevention, Control and Research in China, he is calling for obesity to be listed in China’s framework and policy on health and for intense diet and lifestyle education to halt the growth of obesity.

However: “The means by which this may be accomplished remain elusive,” he admitted.

And how many fat children are there in China, really? The natural bell curve is evident there, as here, as is obesity statisticulation.

Among children 0-6 years of age, 3.4% had BMIs ≥85th percentile and 2% with BMIs ≥95^th percentile on their growth curves. Among children 7 to 17 years of age, using China’s strict definitions, 4.5% had BMIs ≥24 and 2.1% had BMIs ≥28 on their growth curves.

And using the international World Health Organization definition of obesity[BMIs ≥30], only 1.8% of all Chinese children were labeled as obese.

Dr. Snyderman once again misreported a crisis of childhood obesity. While the news went out of its way to film the fattest children and show them eating something fried to convince viewers of the story message, the numbers of fat children in China were overstated by more than five times.

But that wasn’t the most astounding shortfall in the NBC report. They visited a “Fat Reduction Hospital” where fat children are treated with acupuncture. It was reported as being effective for weight loss.

What did Dr. Snyderman say was the weakest link in the hospital’s weight loss program? Acupuncture? She said the greatest weak link in the program was that there was no nutritional counseling.